Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

doi:10.1093/infdis/jiab075

Case Reports

. 2021 May 20;223(9):1522-1527.

doi: 10.1093/infdis/jiab075.

Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

Hassan Tarhini¹, Amélie Recoing^{2

3}, Antoine Bridier-Nahmias³, Mayda Rahi¹, Céleste Lambert⁴, Pascale Martres⁵, Jean-Christophe Lucet^{3

6}, Christophe Rioux¹, Donia Bouzid^{3

7}, Samuel Lebourgeois^{2

3}, Diane Descamps^{2

3}, Yazdan Yazdanpanah^{1

3}, Quentin Le Hingrat^{2

3}, François-Xavier Lescure^{1

3}, Benoit Visseaux^{2

3}

Affiliations

¹ Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
² Laboratoire de Virologie, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
³ Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, Paris, France.
⁴ Unité d'Aval des Urgences, Centre Hospitalier René Dubos, Cergy Pontoise, France.
⁵ Microbiologie, Centre Hospitalier René Dubos, Cergy Pontoise, France.
⁶ Equipe de Prévention du Risque Infectieux, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
⁷ Service d'Accueil des Urgences, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.

PMID: 33556961
PMCID: PMC7928754
DOI: 10.1093/infdis/jiab075

Case Reports

Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

Hassan Tarhini et al. J Infect Dis. 2021.

. 2021 May 20;223(9):1522-1527.

doi: 10.1093/infdis/jiab075.

Authors

Affiliations

¹ Service de Maladies Infectieuses et Tropicales, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
² Laboratoire de Virologie, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
³ Université de Paris, Infection Modelisation Antimicrobial Evolution (IAME), Inserm UMR1137, Paris, France.
⁴ Unité d'Aval des Urgences, Centre Hospitalier René Dubos, Cergy Pontoise, France.
⁵ Microbiologie, Centre Hospitalier René Dubos, Cergy Pontoise, France.
⁶ Equipe de Prévention du Risque Infectieux, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.
⁷ Service d'Accueil des Urgences, Hôpital Bichat Claude Bernard, AP-HP, Paris, France.

PMID: 33556961
PMCID: PMC7928754
DOI: 10.1093/infdis/jiab075

Abstract

Background: Guidelines for stopping coronavirus disease 2019 patient isolation are mainly symptom-based, with isolation for 10 to 20 days depending on their condition.

Methods: In this study, we describe 3 deeply immunocompromised patients, each with different clinical evolutions. We observed (1) the patients' epidemiological, clinical, and serological data, (2) infectiousness using viral culture, and (3) viral mutations accumulated over time.

Results: Asymptomatic carriage, symptom resolution, or superinfection with a second severe acute respiratory syndrome coronavirus 2 strain were observed, all leading to prolonged infectious viral shedding for several months.

Conclusions: Understanding underlying mechanisms and frequency of prolonged infectiousness is crucial to adapt current guidelines and strengthen the use of systematic polymerase chain reaction testing before stopping isolation in immunocompromised populations.

Keywords: COVID-19; SARS-CoV-2; immunocompromised patients; isolation; viral shedding.

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Comment in

Evolution of a 7-Mutant Strain of SARS-CoV-2 Within an Immunocompromised Person May Elucidate the Mechanism for the Generation of New Variants.
Chandra S. Chandra S. J Infect Dis. 2023 Feb 14;227(4):602. doi: 10.1093/infdis/jiac083. J Infect Dis. 2023. PMID: 35255135 Free PMC article. No abstract available.

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Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

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Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection

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